3 Medical Laws All Caregivers Should Know About

July 5, 2017

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caregiver reading and taking notes about legal issues

Medical laws change, but it is important to stay current if caregiving is a responsibility you’ve undertaken for a family member or if it is your profession. There are documents you will need to provide physicians with, as well as decisions to make regarding treatments and facilities.

Here are three of the big ones:

1. HIPAA

HIPAA, the Health Insurance Portability and Accountability Act, came into being in 1996 to help patients gain control over their private information. Only the minimum amount of patient information is available to entities, including caregivers, insurance companies and other health care facilities, unless otherwise directed by the patient.

HIPAA protects patients and holds people accountable for violating the law and patients’ privacy. A violator could spend time behind bars and/or pay a steep fine. However, if a patient requests that their adult child or caregiver accompanies them to a physician appointment or tests, then the provider can release the information. It is clear the patient wants this person to know about their private health information.

The physician has the right to choose who to give pertinent information to if something happens to the patient and they are unable to respond, such as permanent unconsciousness. Even with HIPAA laws in effect, you may want to talk with your patient about a written directive to avoid any miscommunication.

2. The Stark Law

If your patient or loved one is living in a skilled nursing home or assisted living facility, understanding The Stark Law is critical. To avoid conflict of interest and financial kickbacks, The Stark Law puts into effect the protection of Medicare and Medicaid patients. The law states physicians cannot refer patients to a clinic, laboratory or facility and order services in which the provider will receive financial gain in return. This includes a member of a provider’s family.

For example, a physician may be violating The Stark Law if they refer a Medicaid/Medicare patient to a nursing home owned by the physician’s adult child. You want to ensure your patient is receiving the best care and not receiving unnecessary treatment. The Stark Law works to protect patients from unethical practices by enforcing civil fines and penalties and excluding violators from federal health care programs.

If you suspect a physician or facility is violating The Stark Law, you can report the incident to the Office of Inspector General.

3. Legal Documentation Laws

As a caregiver, legal documents are an important part of your responsibility. Your role as a caregiver can be severely limited without proper legal documentation. The following are a few documents you should have on hand and provide copies to your patient’s service providers.

  • Power of Attorney: As power of attorney, you can make medical and financial decisions for your loved one as needed. This document allows you to pay bills on behalf of your patient and make decisions regarding treatments when they no longer can make these decisions on their own.
  • Living Will: Experts suggest creating a living will before the need arises. This document provides a written record of the patient’s wishes regarding life support and treatments and removes the emotional factor during a crisis.
  • Health Care Proxy: If the patient prefers, they can assign a power of attorney to handle their financial responsibilities and a health care proxy to make medical decisions for them regarding treatments. A health care proxy is only used when the patient is permanently unconscious or is in the latter stages of a mental illness.

An elder-law attorney can explain the details of each of the medical laws concerning seniors and caregivers, as well as oversee the legal documentation you need. Before making decisions on behalf of your patient or loved one, make sure you are up-to-date with any changes to the laws.

Image by Unsplash

Written by Kayla Matthews
Kayla Matthews writes about medical technologies and news developments for publications like The Week, BioMed Central and Kareo's Go Practice Blog. To read more posts by Kayla, visit her on Twitter @KaylaEMatthews or check out her website: http://productivitybytes.com.

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6 Comments

  1. I understand there are programs for family members to be paid caregivers, however what does the law say about caregivers working through agencies being health care POA for their patient, is it a conflict of interest?

    Reply
  2. No help for homebound. Or at least not much.

    Reply
  3. Don’t forget filial laws that destroy people

    Reply
  4. My 91 y/o Mom fell 6 months ago and fortunately she was unhurt. I called 911 for a simple lift assist; something I’d done many times before.
    Unfortunately due to the increase in heroin overdoses in my city, it took EMS 2 hours to get here. I made her as comfortable as possible on the floor.
    When they finally arrived, they asked her if she was hurt. She said “yes I need to go to hospital.”
    No matter that she has dementia. No matter that she has lived in my home and I have cared for her full-time for 5 years. No matter that of course she was sore from laying on the floor for 2 hours. No matter that I had power of attorney.
    They put her in an uncomfortable plastic neck brace and took her to the ER where she had to lay with that neck brace for 12 hours, only to be released because she was not injured.
    :'(

    Reply
    • The point being as I discovered the hard way, as long as the patient can speak for themselves, the caregiver’s opinion does not matter.

      Reply

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